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Symptoms to Diagnosis

Acute anxiety and tachycardia in a hospitalized 59-year-old woman

Andres I. Applewhite, MD, Fernando F. Stancampiano, MD, Dana M. Harris, MD, Victor Bernet, MD, Joseph G. Cernigliaro, MD and Jose R. Valery, MD
Cleveland Clinic Journal of Medicine July 2022, 89 (7) 383-391; DOI: https://doi.org/10.3949/ccjm.89a.21002
Andres I. Applewhite
Clinical Research Unit, Mayo Clinic, Jacksonville, FL
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Fernando F. Stancampiano
Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FL
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Dana M. Harris
Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FL
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Victor Bernet
Division of Endocrinology, Mayo Clinic, Jacksonville, FL
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Joseph G. Cernigliaro
Department of Radiology, Mayo Clinic, Jacksonville, FL
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Jose R. Valery
Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FL
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  • For correspondence: [email protected]
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    Figure 1

    Sagittal (left) and horizontal (right) views on computed tomography demonstrate inflammatory changes arising from the chest and tracking superiorly along the neck (arrows).

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    TABLE 1

    The patient’s initial laboratory results

    TestValueaReference range
    Hemoglobin8.5 g/dL11.6–15.0 g/dL
    White blood cell count5.2 × 109/L3.4–9.6 × 109/L
    Segmented neutrophils82%40%–60%
    Platelet count219 × 109/L157–371 × 109/L
    Thyroid-stimulating hormone (TSH)1.04 mIU/L0.3–4.2 mIU/L
    Thyroxine (free T4)1.8 ng/dL0.9–1.7 ng/dL
    Lactate0.8 mmol/L0.5–2.2 mmol/L
    C-reactive protein64 mg/L≤ 8 mg/L
    Erythrocyte sedimentation rate78 mm/hour0–30 mm/hour
    Sodium138 mmol/L135–145 mmol/L
    Potassium4.2 mmol/L3.6–5.2 mmol/L
    Chloride102 mmol/L98–107 mmol/L
    Bicarbonate25 mmol/L22–29 mmol/L
    Magnesium1.9 mg/dL1.7–2.3 mg/dL
    Calcium8.9 mg/dL8.6–9.6 mg/dL
    Blood urea nitrogen27 mg/dL6–21 mg/dL
    Serum creatinine1.2 mg/dL0.59–1.04 mg/dL
    Glucose95 mg/dL70–140 mg/dL
    Alanine aminotransferase53 U/L7–45 U/L
    Aspartate aminotransferase49 U/L8–48 U/L
    Alkaline phosphatase121 U/L46–118 U/L
    Albumin3.7 g/dL3.5–5.0 g/dL
    Total protein6.5 g/dL6.3–7.9 g/dL
    Bilirubin0.8 mg/dL≤ 1.2 g/dL
    Gamma-glutamyl transferase42 U/L5–36 U/L
    Lactate dehydrogenase216 U/L122–222 U/L
    Prothrombin time10.3 seconds9.4–12.5 seconds
    • ↵a Abnormal results are shown in bold.

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Cleveland Clinic Journal of Medicine: 89 (7)
Cleveland Clinic Journal of Medicine
Vol. 89, Issue 7
1 Jul 2022
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Acute anxiety and tachycardia in a hospitalized 59-year-old woman
Andres I. Applewhite, Fernando F. Stancampiano, Dana M. Harris, Victor Bernet, Joseph G. Cernigliaro, Jose R. Valery
Cleveland Clinic Journal of Medicine Jul 2022, 89 (7) 383-391; DOI: 10.3949/ccjm.89a.21002

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Acute anxiety and tachycardia in a hospitalized 59-year-old woman
Andres I. Applewhite, Fernando F. Stancampiano, Dana M. Harris, Victor Bernet, Joseph G. Cernigliaro, Jose R. Valery
Cleveland Clinic Journal of Medicine Jul 2022, 89 (7) 383-391; DOI: 10.3949/ccjm.89a.21002
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